THE COLUMBUS FOUNDATION

Mary Eleanor Morris Scholarship

Logan County, Ohio

Directions to the Applicant:

Please fill in all of the information requested as fully and accurately as you can. This application must be returned to the Midwest Regional Educational Service Center, 121 S. Opera St., Bellefontaine, Ohio 43311-2080 by March 1, 2016. Please type the information requested. Give your recommendation sheet to a person you know well. (Do not include relatives.) Please ask them to mail the completed recommendation directly to the Midwest Regional Educational Service Center.

Students who are recipients of the National Merit Scholarships of $4000.00 or more are not eligible.

Last Name / First Name
Address / City, State, Zip Code
Phone Number / Student Number (to be completed by committee)
Do you live in Logan County? / Yes / No
You are presently a senior at what high school:
Other high schools I have attended: /

High School

/

Dates Attended

I have given a recommendation sheet to: /

Name of Person

/

Position

Please write and attach a brief paragraph (no more than 100 words) explaining why you feel you should receive this award. Please note any special circumstances especially as they relate to your financial needs.
To the best of my knowledge, all of the information provided in this application is accurate.

***** Counselor: Please attach

an official transcript to ______this application. Applicant’s Signature

______

Parent’s (Guardian’s) Signature

______

School Counselor’s Signature

Applicant: Please complete the following information.

1. My latest rank is / out of / members in my class.
2. My latest grade point average is / This is based on / semesters of work.
3. The courses I am taking this year are: (Please list the first semester grade for each.)
a. / b.
c. / d.
e.
4. My ACT Composite score is / or SAT Verbal and Math scores are
5. I have participated in the following high school activities:
6. I have participated in the following out-of-school activities:
7. I have been accepted at, and plan to attend
I plan to major in
8. I have already received scholarships, grants, or loans totaling
9. Per year, my parent(s)/guardian(s) can give me about / to help defray expenses. (Please consider all possible sources of assistance.)
10. I expect to contribute from savings, summer work, full or part-time work,
social security payments, etc., about / to help defray expenses.
11. The combined income of both my parents or guardians for last year was
(To be taken from the last Federal income tax return.)
My parent(s) or guardian(s) claimed / dependents on the last federal income tax return.
12. The combined assets of my parents or guardians are as follows:
Value of home minus outstanding mortgage:
Value of farm, land, equipment, etc. minus outstanding mortgage:
Value of family owned business minus outstanding mortgage:
Value of miscellaneous assets (stocks, bonds, certificates, savings accounts, etc.):
Total assets minus outstanding mortgages:
Please use the space provided below to explain any circumstances (for example-older brothers or sisters in college,
unemployment, etc.):

The information provided in this section of the application will be kept confidential.

Mary Eleanor Morris Scholarship

RECOMMENDATION SHEET

Please mail this completed recommendation to Midwest Regional Educational Service Center,

121 S. Opera St., Bellefontaine, Ohio, 43311-2080 by Tuesday, March 1, 2016.

Please be as accurate and honest as you can when you complete this recommendation for ______a student at______.

1. I have known this student for _____ year(s), and I have known this student as a (teacher, Boy/Girl Scout leader, coach, etc.) ______.

2. Comment on this student’s character, as you know it.

3. Comment on this student’s citizenship ability, as you know it.

4. Do you feel this student is worthy of a scholarship? ____ Yes ____ No

Please explain:

______

Signature

Rev. 5/13